ArticleNutrition & metabolism2024
Impact of early high protein intake in critically ill patients: a randomized controlled trial.
Article in Nutrition & metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of protein intake on kidney adverse events in critically Ill patients: a systematic review and meta-analysis.International urology and nephrology · 2026Pooled it
- Presleep vs. Daytime Consumption of Casein-Enriched Milk: Effects on Muscle Function and Metabolic Health After Sleeve Gastrectomy.Nutrients · 2025Trial
- Comment on: "The impact of protein intake on kidney adverse events in critically ill patients: a systematic review and meta-analysis".International urology and nephrology · 2026Article
- Personalized protein delivery in critical care: from phenotyping and endotyping to post-ICU recovery.Current opinion in critical care · 2026Review
- Amino Acids as Metabokines in Hypercatabolic States: Rethinking Nutritional Protein-Based Strategies Beyond Caloric Support.Nutrients · 2026Review
- Perioperative nutritional status in cardiac surgery patients: a multicenter observational study in Shanghai, China.General thoracic and cardiovascular surgery · 2026Observational
- Effect of dietitian-guided nutritional support on intensive care units length of stay and nutritional risk in critically Ill patients.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2026Article
- Explainable Machine Learning Model Based on Routine Admission Laboratory Tests for Predicting New-Onset Hypoalbuminemia in Hospitalized Older Patients with Acute Exacerbation of COPD.Clinical interventions in aging · 2026Article
- Protein nutritional support in critically ill patients: pathophysiological basis, clinical evidence, and areas of uncertainty - a narrative review.Frontiers in medicine · 2026Review
- Author Response: Challenges in Implementing High Protein Nutrition for ICU Patients.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2025Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundConflicting findings regarding the impact of High protein intake during the early phase in critically ill patients have been reported. Therefore, we aimed to assess the influence of higher early protein intake on the prognosis of critically ill patients.
methodsThis randomized controlled trial involved 173 critically ill patients who stayed in the Intensive Care Unit/Emergency ICU (ICU/EICU) for at least 7 days. The Low group (n = 87) and High group (n = 86) received protein supplementation of 0.8 g/kg.d and 1.5 g/kg.d, respectively, within 1-3 days of enteral nutrition (EN) initiation, with both groups transitioning to 1.5 g/kg.d on the 4th day. The serum prealbumin (PA), blood urea nitrogen/creatinine, and rectus femoris muscle thickness and cross-sectional area of all patients was measured on the 1th, 3rd, 5th, 7th day, and the day of ICU/EICU discharge.
resultsPatients in both Low and High groups showed no significant differences in age, APACHE II scores, or other demographic and baseline characteristics. There were also no significant differences in the primary outcome (28-day mortality rate) and secondary outcomes (incidence rate of refeeding syndrome and EN tolerance score) between the two groups. However, the Low group exhibited a significantly higher 28-day mortality rate (HR = 2.462, 95% CI: 1.021-5.936, P = 0.045) compared to High group, as determined by Cox proportional hazards models incorporating the time factor. The High group exhibited significantly shorter durations of mechanical ventilation and ICU stay compared to the Low group. Serum PA levels were higher, and rectus femoris muscle atrophy rates were lower in the High group. Furthermore, for septic patients, high protein intake significantly reduced the 28-day mortality rate despite a small sample size (n = 34).
conclusionsOur study indicates that increasing early protein intake to 1.5 g/kg.d may be safe and help improve the nutritional status and prognosis of critically ill patients.
trial registrationThis study was registered with the Chinese Clinical Trial Registry (ChiCTR2000039997, https://www.chictr.org.cn/ ).
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